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About Open-Heart Surgery

How Does the Heart Work?

As the strongest muscle in the body, the heart is responsible for
pumping 4 to 8 liters of blood per minute to supply oxygen and
nutrients to the circulatory system. 1

Within the heart, there are four chambers that work in
coordination. The right side receives deoxygenated blood from the
body and transfers it to the lungs, while the left side works to
move the oxygenated blood from the lungs to the rest of the body. 2

How Does Blood Flow Through the Heart?

To understand blood flow, the easiest thing to remember is that
veins move blood towards the heart and arteries move blood towards the
body and other organ systems.2

While the heart contracts and expands, four valves control the flow
of blood in and out of the heart ensuring that blood is pumped in the
correct direction. These valves are known as the mitral valve,
tricuspid valve, aortic valve and the pulmonary valve. These valves
open to let the blood move ahead, then quickly close to keep the blood
from flowing backward. 2

Patient Education Materials

Information & Resources

Common Open Heart Surgeries

Coronary Artery Bypass Graft

Coronary artery disease occurs when plaque builds up in the
coronary arteries preventing the heart from getting the enriched
blood it needs. When the blood vessels that transport blood become
narrow due to plaque build-up, a coronary artery bypass graft
(CABG), needs to be performed. This is also called bypass surgery.3

In this procedure, the surgeon uses a section of vein sourced
from another part of the body, such as the leg, to make a new route
for blood supply to the heart muscle. Oxygen-rich blood will be
rerouted around the narrowed or blocked section of the coronary
artery and into the heart muscle. If there are multiple blockages,
then the procedure may require multiple bypasses.3

The image above shows how the valves of the heart open and close in sync
with each other to pump blood through the heart. The closing of the
valves creates the “lub dub” sound heard when listening to the heart.

Valve Repair and Replacement

The heart has four valves that open and close in a steady rhythm
to pump blood through the four chambers of the heart in the correct
direction. These valves can malfunction for a variety of reasons
including bacterial infection, congenital heart defects or coronary
artery disease.4

The aortic valve and the mitral valve are most commonly replaced,
while pulmonary and tricuspid valve replacements are uncommon in
adults. Valve repair and replacements are mostly caused by
regurgitation or stenosis.4

Regurgitation occurs when the valve does not close properly
causing the blood to flow backward through the valve and into the
heart instead of moving it forward and out to the body. This forces
the heart to work harder to pump blood through the body.4

Stenosis, or narrowing of the valve, is caused when valve tissue
has thickened or fused together, causing a reduction in blood flow
because the valve will not open as well as it should.4

A surgeon may opt to repair or replace a malfunctioning valve
with a mechanical valve made of metal or with valve tissue from a
cow, pig or human donor. Most of the time, heart valve replacement
or repair is an open-heart operation. In some cases, the valve can
be replaced or repaired without opening the chest, such as in a
transcatheter aortic valve replacement (TAVR) procedure.

How is the Heart Accessed?

If you are having open-heart surgery, your surgeon will access
the heart by making an incision vertically down the center of your
chest. The size of the incision varies depending on the type of
surgery being performed. After the incision is created, the
breastbone (sternum) will be cut to access your heart. This process
is called a sternotomy.5

Wire closure

How is the chest wall closed?

Following the operation, a surgeon will close the breastbone by
bringing the two halves back together. While other bones of the body
are fixed with plate and screw technology, the breastbone is still
primarily closed with surgical steel wires.5

One of the alternatives to wire closure is rigid fixation; the use
of metal plates and screws to immobilize fractured bone. The
SternaLock Blu Study showed that patients treated with SternaLock Blu
showed improved sternal healing, fewer breastbone complications and
improved recovery when compared to patients treated with wires. For
more information see the SternaLock
Blu Study & Product page.6, 7

SternaLock Blu (rigid fixation) closure

After the breastbone closure, your surgeon will sew the tissues and
muscles together with stitches or sutures. Most operations will take
approximately three to six hours depending on the complexity of the procedure.8

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The information herein is of a general nature and does not represent
or constitute medical advice or recommendations and is for
general education purposes only. The information includes descriptions
of a medical device that a thoracic (heart) surgeon may choose for
patients undergoing open-heart surgery.

Zimmer Biomet manufactures medical devices, including metal plates
and screws that may be used by your heart surgeon to hold together the
sternum (breastbone) after heart surgery. We do not practice medicine;
all questions regarding your medical condition must be directed to
your doctor(s).

Results with breastbone (sternum) plates and screws (rigid fixation)
will vary due to health, weight, activity and other variables. Not
all patients are candidates for this product and/or procedure. Only a
medical professional can determine the treatment appropriate for your
specific condition. Appropriate post-operative activities will differ
from patient to patient. Talk to your surgeon about whether rigid
fixation is right for you and the risks associated therewith,
including but not limited to the risks of infection, implant wear,
loosening, screw or plate breakage or incomplete bone healing. For a
complete list of risks associated with Zimmer Biomet’s rigid fixation
system, see Patient
Risk Information.

The SternaLock Blu study was funded by Zimmer Biomet.

All content herein is protected by copyright, trademarks and other
intellectual property rights, as applicable, owned by or licensed to
Zimmer Biomet or its affiliates unless otherwise indicated, and must
not be redistributed, duplicated or disclosed, in whole or in part,
without the express written consent of Zimmer Biomet.

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